Nurse Independent Prescriber?

Nurses General Nursing

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Is this an RN who has prescription authority in the United States?

Can anyone tell me more about the role and education needed?

Specializes in Education, FP, LNC, Forensics, ED, OB.
Can a nurse administer prescription strength drugs without a doctor's orders if the nurse feels it necessary?

O.k., you changed your post. You now say, "without", an order.

No, nurses cannot administer medications without an order from a Physician or APN.

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That would be prescribing, and would only be possible (legally) if the nurse had her/his own prescriptive authority.

I'm getting it now. Thanks. A nurse may only administer OTC drugs if he or she feels it necessary, but must have a doctor's order for prescription drugs.

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Specializes in Education, FP, LNC, Forensics, ED, OB.

No, that's not what we said. And, you are saying two different things in your last post.

A nurse cannot administer drugs without an order from a Physician or APN.

A nurse exercises nursing judgment and can administer any drug WITH a Physician order or APN order.

But, a nurse may not administer a drug (Prescription or otherwise) w/o an order from a Physician or APN.

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I'm getting it now. Thanks. A nurse may only administer OTC drugs if he or she feels it necessary, but must have a doctor's order for prescription drugs.

I've never worked anywhere where nurses could give OTC medications without a physician's (or other authorized prescriber's) order. RNs and LPNs administer medications, they don't prescribe them (even OTC).

Where I work, staff nurses have to have a physician's order for Carmex lip balm, saline nasal spray, and other things that don't even have anything in them that you would consider a "drug."

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Specializes in Advanced Practice, surgery.

Hope you don't mind me jumping into your thread here, could I ask the ANP's here what do you have to go through in the US to gain prescriptive authority, is it part of your ANP course and does that cover you wherever you work in the country or are there differences?

Are there limitations to what you can prescribe? and are you truly independent prescribers or do you need to have a physician to underwrite your prescriptions?

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I've never worked anywhere where nurses could give OTC medications without a physician's (or other authorized prescriber's) order. RNs and LPNs administer medications, they don't prescribe them (even OTC).

Where I work, staff nurses have to have a physician's order for Carmex lip balm, saline nasal spray, and other things that don't even have anything in them that you would consider a "drug."

Doesn't that demean a nurse's common sense and knowledge base? Do you consider yourself intelligent enough not to kill a patient with lip balm, nasal spray, or cough drops?

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Hope you don't mind me jumping into your thread here, could I ask the ANP's here what do you have to go through in the US to gain prescriptive authority, is it part of your ANP course and does that cover you wherever you work in the country or are there differences?

Are there limitations to what you can prescribe? and are you truly independent prescribers or do you need to have a physician to underwrite your prescriptions?

Thank you for the added question. I'd really like to know this as well.

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Hope you don't mind me jumping into your thread here, could I ask the ANP's here what do you have to go through in the US to gain prescriptive authority, is it part of your ANP course and does that cover you wherever you work in the country or are there differences?

Are there limitations to what you can prescribe? and are you truly independent prescribers or do you need to have a physician to underwrite your prescriptions?

There's no single answer to your questions, Sharrie -- each US state regulates the practice of nursing, including advanced practice nursing, within its own boundaries, and the requirements vary from state to state (there's a lot of "overlap," obviously, just as with basic, general nursing practice -- but there are some significant, important differences from state to state). Advanced practice nursing graduate programs include education and clinical practice in prescribing, within the context of the particular specialty being studied and within the rules/regulations related to advanced practice in the state in which the school is located.

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but what about standing orders and protocols? can't nurses make clinical judgements and administer meds within the framework of protocols and standing orders?

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Doesn't that demean a nurse's common sense and knowledge base? Do you consider yourself intelligent enough not to kill a patient with lip balm, nasal spray, or cough drops?

I'm not saying I think it's a good or necessary idea (although I have known plenty of nurses over the years I wouldn't trust with lip balm or nasal spray) -- just that it is the law. If people want to be able to prescribe, they need to plan on becoming a physician, APN, or PA. Generalist nurses administer meds, that's all. If people have a big problem with that, they're probably not going to be happy in nursing.

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but what about standing orders and protocols? can't nurses make clinical judgements and administer meds within the framework of protocols and standing orders?

Another good question I'd like an answer to. So many questions, so little time.

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I'm not saying I think it's a good or necessary idea (although I have known plenty of nurses over the years I wouldn't trust with lip balm or nasal spray) -- just that it is the law. If people want to be able to prescribe, they need to plan on becoming a physician, APN, or PA. Generalist nurses administer meds, that's all. If people have a big problem with that, they're probably not going to be happy in nursing.

I'll be happy, if not at least content passing meds.

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